CMS Price Transparency Data

Colonoscopy (diagnostic)

Facility: Lower Keys Medical Center

Billing Code: 45378 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 45378
  • Insurance Median: $1,127
  • Cash Discount Price: $3,032
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Colonoscopy (diagnostic) at Lower Keys Medical Center is $1,127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,032. Compared to the federal Medicare reimbursement reference rate of $950.1, this hospital’s rate is 1.19x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$3,032

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,127

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$950.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $950.1 (100%)
Cash / Self-Pay: $3,032 (319%)
Insurance Median: $1,127 (119%)
Cash: $3,032 (319% of Medicare)
Ins. Median: $1,127 (119% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $950.1 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
UnitedHealthcare $62 - $8,635 7%
Veterans Eval Services $322 34%
Florida Childrens Medical Services $972 102%
Medicaid / KanCare $972 - $1,069 102%
South Florida Community Care Network $972 102%
Tricare $988 104%
Humana $1,001 - $1,023 105%
Blue Cross Blue Shield $1,023 - $13,432 108%
Medicare (plans) $1,023 108%
Ultimate Health $1,023 108%
Node Champva $1,040 109%
Node Non Par Hospice Agree $1,040 109%
Node United Behavioral Va Ccn $1,040 109%
Node Va $1,040 109%
Amerigroup $1,069 113%
Positive Healthcare $1,069 113%
Simply Healthcare $1,069 - $3,000 113%
Wellcare $1,069 113%
Wellcare Healthease $1,069 113%
Molina $1,098 116%
Prestige Health Choice $1,127 119%
Correct Care Solutions $1,144 120%
Magellan $1,166 123%
Node Us Dept Of Labor $1,300 137%
Prime Health Work Comp Fl $1,916 202%
Fl Work Comp $1,975 208%
Heritage Summit Work Comp Fl $1,975 208%
State Auto Insurance Fl $2,080 219%
Self Pay $3,032 319%
Cigna $6,625 697%
Aetna $7,838 825%
Monroe County $8,422 886%
Evolutions Healthcare Systems $8,983 - $10,668 945%
Keys Energy $8,983 945%
Prime Health Ppo $8,983 945%
Avmed Health Plan $9,545 1005%
Direct Healthcare $11,229 1182%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals